If you are over the age of 34 and pregnant, you will probably get the "AMA talk." AMA stands for advanced maternal age. This talk usually involves a discussion about birth defects. If you get your care with us, it would also include some special measures in the third trimester related to prevention of stillbirth. I wrote this entry in hopes of relieving some of the anxiety that may go along with discussing such a scary topic.

First, let's go over some facts. In the last decade, several large studies have been published on stillbirth in women over the age of 35. In this group, there appears to be an increase in the rate of stillbirth when compared to women younger than 35. At an age greater than 37, those risks increase especially quickly in the late third trimester. Some studies describe this late third trimester risk as 5 times greater than the risk for women under the age of 24.

Thinking about the risk of rare but terrible events like stillbirth can be anxiety-provoking and sometimes downright scary. However, an increased risk is quite different than a high risk. For instance, our risk of being hit by lightening increases during a thunderstorm. The true risk of actually being struck, on the other hand, is not high (about 1 in 250,000 in New Mexico). So, should you stay indoors if possible? Absolutely. Should you let a thunderstorm ruin your weekend with fear? Probably not.

Lightning over Rio Rancho. Composite exposure by Bryan Sanchez.

At Pinon Perinatal, we offer weekly biophysical profiles for women over the age of 37 during the last month of the pregnancy. This is our version of taking a reasonable precaution to avoid the storm. The timing of delivery may also be worth considering. At 39 weeks and 0 days, the fetus is as mature as it will ever be while in the womb. If the cervix is soft and naturally dilated, it may be reasonable to start labor for women over the age of 37 in order to minimize the risk of stillbirth.

Regardless of the strategy used, it is important to remember that stillbirth is a very rare event. So, relax and enjoy the wonders of pregnancy as best you can. Leave the worrying up to us!